The prospect of Deep Medicaid Cuts has become a flash point in the Congress, the leaders of the two parties accusing their counterparts of lie.
The Democratic Manager of Hakeem Jeffries said February 27 That a republican budgetary measure “would trigger the greatest reduction in Medicaid in American history” and that the Republicans hide the consequences.
“The Republicans lie to the American people about Medicaid”, ” Jeffries said. “I can’t say it differently. The Republicans lie. Prove me the opposite.
The Republicans said that Democrats distort the republican budget. Representative Steve Scalizes (R-La.)“The word” Medicaid “is not even in this bill.” Mike Johnson room president said on cnn That the Republicans do not want to cut Medicaid, “and the Democrats lied about it.”
The Republicans are looking for massive budgetary savings to achieve their objective of fully prolonging President Donald Trump’s tax cuts in 2017. This is a process distinct from the need for Congress to adopt a continuous resolution to maintain the government in execution by March 14 or cope with a closure of the federal government.
Here is what we know so far on the potential cups of Medicaid.
The home budget of the GOP of the house requires $ 880 billion in cuts
Medicaid is used to approximately 1 out of 5 Americans. The low -income health care program is paid by the federal government and partly by states. LouisianaWho houses Johnson and scratches, has one of the highest proportions of the registrants of Medicaid.
THE House republican budgetary plan Adopted on February 25 opens the door to the reduction of Medicaid, even if it does not name the program. The plan orders the Chamber’s Energy and Trade Committee to find ways to reduce the deficit by at least $ 880 billion in the next decade.
The Committee has competence on Medicaid, Medicare and the health insurance program for children, in addition to much smaller programs. Chip offers low -cost health coverage To children of families who earn too much money to qualify for Medicaid.
The Republicans have excluded medical cuts, the health insurance program for the elderly that leaders have reduced their political risk. Medicare is about 15% of the federal budgetAnd Medicaid is around 8.6%.
When Medicare is canceled, Medicaid represents 93% of the financing under the jurisdiction of the committee, the budget of the non -partisan congress budget found in a March 5 analysis. This means that it is impossible for the committee to find enough cuts that do not affect Medicaid.
“It is a fantasy to involve that the federal assistance of Medicaid will not be reduced very deeply,” said Allison Orris, expert in Medicaid policy at the Center for Budget and Political Priorities, a leftist thinking group.
After Medicaid, the following program under the jurisdiction of the committee is chip. The legislators do not seem to plan to eliminate the chip, but even if they did, they would be only a “fraction of the path,” said Joan Alker, expert at Medicaid and Chip at the University of Georgetown.
If Medicare Cuts is out of the table, the only way to reach $ 880 billion in savings is from Big Medicaid Cuts, said Larry Levitt, executive vice-president of health policy at KFF, research in health research, survey and press organization that includes Kff Health News.
Andy Schneider, professor at the University of Georgetown who served in the Obama administration as a main advisor to the Centers for Medicare & Medicaid Services, said that even if the committee eliminated all these “other” programs.
“In short, if they do not want to cut Medicaid (or chip), and they do not want to cut Medicare, the goal of cutting $ 880 billion is impossible,” said Schneider.
The reduction of $ 880 billion is not a matter concluded. The Republicans of the Chamber were able to spend their budgetary whole, but the Republicans of the Senate adopt a different approach, without offering such significant cuts.
Any finalized budgetary plan would need the membership of the Senate Republicans. Senator Josh Hawley (R-MO.) Is among the Republicans who have spoken against Potential cuts; he said HuffPost“I would not do serious focus in Medicaid.”
Figures are starting points that can lead to negotiations between the Republicans, said Joseph Antos, a health care expert at the Conservative American Enterprise Institute. “We are far from the final legislation, so it is not possible to predict how many programs will be reduced,” he said.
“If the bill also includes the extension of tax reductions (Trump 2017), we are probably months of seeing real language,” said Antos.
Once the Chamber and the Senate have entered into an agreement on the language and the resolution adopts the two chambers, the committees will work on detailed cuts. To adopt such cuts, the two chambers should approve a separate bill and receive Trump’s signature.
Why elimination of fraud does not solve the problem
Republican leaders have deflected concerns about the Medicaid cuts speaking of a different target: Medicaid fraud.
“I’m not going to touch Social Security, Medicare, Medicaid. Now we are going to get out of the fraud of there, “Trump told Fox News, Maria Bartiromo March 9In accordance with his campaign rhetoric that he would protect these programs.
At the same time, Trump on his social platform of truth rented the resolution of the house which would make the cuts very likely: “The resolution of the house implements my first Full America program, everything, not only parts of it!”
Would the elimination of fraud solve the problem of Medicaid? No.
On CNN, Johnson said The reduction of fraud, waste and abuse would lead to a “part of the savings to accomplish this mission”. He said the government loses $ 50 billion a year in Medicaid “just in fraud alone”.
Johnson confused “fraud” with “inappropriate payments”. THE Government officethe non -partisan investigation arm which examines the use of public funds, found about $ 50 billion In inappropriate payments to Medicaid and the same amount in Medicare during the year 2023.
These inappropriate payments were made of an incorrect amount (too paced or underpaid), should not have been carried out at all, or had missing or insufficient documentation. But that does not mean that there were $ 50 billion in Medicaid fraud, which would involve obtaining something by a false deliberate declaration.
The system used to identify inappropriate payments is not designed to measure fraud, so we do not know what percentage of inappropriate payments was losses due to fraud, said Schneider, the former health advisor of the Obama administration.
In addition, it is a drop in the overall bucket of 880 billion potential dollars of cuts.
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